This application is for a one-year healthcare information technology planning project led by Hancock County Memorial Hospital in partnership with Belmond Medical Center, Ellsworth Municipal Hospital, Franklin General Hospital, Regional Health Services of Howard County, Kossuth Regional Health Center, Mercy Medical Center-New Hampton, Mitchell County Regional Health Center, and Palo Alto County Health System. Through this project, these nine small, rural, north Iowa medical centers will follow a six-step planning process with the assistance of a medical informatics consultant and a rural healthcare information technology (HIT) consultant to design a three-year plan to implement an integrated electronic health record (EHR) system for their hospitals and 21 affiliated physician health organization clinics. They will also collaborate with Mercy Medical Center-North Iowa, a closely affiliated secondary referral center, and nine county public/community health agencies to develop compatible HIT infrastructures, standardized protocols, and procedures for effectively and securely exchanging patient information. The project has two major goals. 1) To complete a successful system-wide, patient-centered planning process led by physicians, nurses, and other clinicians across these organizations in collaboration with administrators, information system staff, and expert consultants. 2) To produce a comprehensive, achievable three-year EHR implementation plan that will: a) effectively, confidentially, and securely exchange patient information within and across the partners' diverse healthcare settings--acute care, outpatient, clinic, home health, hospice, and long-term care; b) increase evidence-based care practices; and c) lead to significant, measurable, and sustainable improvements in patient safety and quality of care, as well as increased organizational and financial efficiencies. [unreadable] [unreadable] [unreadable]